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A Murine Model of Dengue Virus-induced Acute Viral Encephalitis-like Disease
Published on: April 28, 2019
Clinical Picture and Risk Factors for Severity of SARS-CoV-2 and Dengue Coinfection in Children: Experience From a
Nguyen The Nguyen Phung1, Minh Nhut Tran2, Thanh Thuc Tran1
1Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM.
Insights
COVID-19 and dengue coinfection in Vietnamese children often resulted in mild COVID-19. However, overweight/obesity, abdominal pain, and petechiae were identified as key risk factors for severe outcomes in pediatric coinfection cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Dengue poses a significant health burden in Asia-Pacific and Latin America.
- The COVID-19 pandemic created a "double burden" in endemic areas due to coinfection risks, particularly for children.
- Pediatric coinfection with COVID-19 and dengue presents unique challenges and vulnerabilities.
Purpose of the Study:
- To describe the clinical characteristics of children with COVID-19 and dengue coinfection in Vietnam.
- To identify risk factors associated with severe outcomes in pediatric coinfection cases.
- To understand the impact of coinfection during the COVID-19 pandemic on vulnerable populations.
Main Methods:
- Retrospective cohort study at Children's Hospital 1, Ho Chi Minh City, Vietnam.
- Inclusion criteria: Children under 16 diagnosed with SARS-CoV-2 and dengue coinfection during the fourth COVID-19 wave (April 2021–June 2022).
- Analysis of patient demographics, comorbidities, clinical presentation, and disease severity.
Main Results:
- 31 pediatric patients with coinfection were analyzed; 61.3% were male, median age 10.8 years.
- 45.2% had comorbidities, most commonly overweight/obesity (10 children).
- Most cases had mild COVID-19 (83.9%) and dengue without/with warning signs (61.3%). Fever (93.6%), abdominal pain, vomiting, and petechiae were common. Overweight/obesity, abdominal pain, and petechiae were linked to severe disease. No deaths occurred.
Conclusions:
- Most children experienced mild COVID-19, with disease progression similar to dengue alone.
- Severe COVID-19 and dengue coinfection can occur in some pediatric cases.
- Overweight/obesity, abdominal pain, and petechiae are independent risk factors for severe coinfection in children.
Abstract:
Introduction Dengue is an infectious disease that is a burden in Asia-Pacific and Latin America. The COVID-19 pandemic in dengue-endemic areas has caused a "double burden" because of the possibility of coinfection, especially in children who are vulnerable to both COVID-19 and dengue. This study aimed to describe the characteristics and identify risk factors for the severity of the coinfection in Vietnamese children. Methods This was a retrospective cohort study, undertaken at Children's Hospital 1 (Ho Chi Minh City, Vietnam) during the fourth wave of the COVID-19 pandemic. All children under 16 years old who were admitted to the hospital from April 27, 2021 to June 30, 2022, and diagnosed with SARS-CoV-2 and dengue coinfection were included. Results From April 2021 to June 2022, a total of 31 patients with the coinfection were included, with 19 of them being male (61.3%). The median age was 10.8 years old (IQR, 5.1-14.1). Fourteen children (45.2%) had preexisting comorbidities, with the most common comorbidity being overweight/obesity (ten children). Nearly two-thirds of the children were diagnosed with dengue without/with warning signs (61.3%) and were classified as having mild COVID-19 (83.9%). The most frequently observed clinical characteristics were fever (n=29, 93.6%), followed by abdominal pain, vomiting, and petechiae. All patients had high serum ferritin, and 83.9% presented with thrombocytopenia. None of the cases died. Overweight/obesity, abdominal pain, and petechiae were factors independently associated with severe disease. Conclusion Most of the children had mild COVID-19 and disease progression similar to patients with dengue alone. However, some children may have severe COVID-19 and dengue coinfection. Obesity, abdominal pain, and petechiae were identified as independent risk factors for disease severity in pediatric cases. Further studies with multicenters and a larger sample size are needed to assess the coinfection more thoroughly.
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